Healthcare simulation has emerged as a critical tool in nursing that offers a dynamic and interactive method for training nurses in a controlled, risk-free environment. Since 2020, there has been a growing body of research that explores the impact of simulation-based learning on nursing competency, confidence, and self-efficacy. These studies offer valuable insights into the effectiveness of various simulation modalities and their role in the preparation of nurses for real-world clinical challenges. This HealthySimulation.com article by Melissa Jo Tully, MHPE, RN, CPHN, will review the role of simulation in competency-based nursing education to improve confidence and self-efficacy.
The Role of Simulation in Nursing
Simulation-based education allows nursing students and practicing nurses to engage in realistic clinical scenarios that mirror the complexities of actual patient care. These simulations can range from low-fidelity exercises, such as role-playing, to high-fidelity simulations using advanced manikins and virtual reality environments. The primary goal is to enhance clinical skills, improve decision-making, and foster critical thinking, all of which are essential for competent nursing practice.
Research has consistently shown that simulation-based training positively impacts nursing students’ and practicing nurses’ knowledge, skills, and confidence. For instance, a study comparing high-fidelity simulation (HFS) with virtual simulation (VS) found that both modalities significantly improved nurses’ knowledge, self-efficacy, and clinical skills, although each had unique strengths. High-fidelity simulations, which use sophisticated manikins that replicate human responses, were particularly effective in developing hands-on skills and clinical decision-making. In contrast, virtual simulations provide flexibility and accessibility, making them ideal for ongoing professional development (Alrajhi et al., 2022; Johnson & Smith, 2021).
View the LEARN CE/CME Platform Webinar Measuring Your Simulation Program Success to learn more!
Simulation and Self-Efficacy in Nursing
Self-efficacy, or the belief in one’s ability to succeed in specific situations, is a critical factor in nursing. High levels of self-efficacy are associated with better clinical performance and greater resilience in the face of challenging situations. Simulation-based learning has been shown to significantly enhance self-efficacy among nursing students and practicing nurses.
A quasi-experimental study conducted in 2021 investigated the impact of simulation-based education on the self-efficacy and clinical performance of nursing students. The study found that students who participated in simulation-based training demonstrated significantly higher levels of self-efficacy compared to those who received traditional classroom-based education. This increase in self-efficacy translated into improved clinical performance, particularly in areas such as patient assessment, nursing diagnoses, and the implementation of care plans (Lee et al., 2021).
Furthermore, virtual simulations have also proven effective in boosting self-efficacy, especially in the context of pandemic-related scenarios. A study on virtual nursing simulation programs designed to provide psychological support during infectious disease outbreaks found that participants exhibited increased self-efficacy in managing such crises. This is particularly important given the ongoing need for healthcare professionals to adapt to rapidly changing and high-stress environments (Kim & Park, 2023).
Impact on Competency and Confidence
Competency in nursing involves the integration of knowledge, skills, and attitudes to provide safe and effective care. Confidence, closely related to self-efficacy, is the assurance a nurse has in their abilities to perform tasks competently. Simulation training has been shown to significantly enhance both competency and confidence in nursing practice.
A 2022 study comparing the effects of traditional and simulation-based teaching methods found that simulation participants reported higher levels of confidence in their clinical abilities. The study highlighted that the experiential nature of simulation, coupled with immediate feedback and the opportunity for reflection, helps nurses internalize learning and with application in real-world settings. This, in turn, leads to more competent and confident practitioners who are better prepared to handle the complexities of patient care (Alrajhi et al., 2022).
Moreover, the effect size of simulation training on nursing competency has been a focus of recent research. Effect size measures the strength of the relationship between two variables, and in the context of simulation-based education, helps quantify the impact of these training methods on nursing outcomes. Studies have found medium to large effect sizes for simulation training in improving clinical competencies, particularly in high-fidelity simulations where the realism and interactivity closely mimic actual clinical environments (Johnson & Smith, 2021).
As the healthcare landscape continues to evolve, the role of simulation in nursing education is likely to expand. Advances in technology, such as augmented reality (AR) and artificial intelligence (AI), are opening new possibilities for immersive learning experiences that further enhance nursing competency and confidence. Additionally, the ongoing development of virtual simulation platforms provides greater accessibility, enabling continuous learning and professional development beyond the traditional classroom.
However, educators and healthcare institutions must carefully consider the design and implementation of simulation programs. The effectiveness of simulation training depends not only on the fidelity of the simulations but also on the quality of debriefing sessions, the integration of evidence-based scenarios, and the alignment with learning objectives.
Healthcare simulation has proven to be a transformative tool in nursing education, significantly enhancing the competency, confidence, and self-efficacy of nursing professionals. The body of research since 2020 underscores the value of simulation-based learning in preparing nurses for the demands of clinical practice. As simulation technology continues to advance, its role in nursing education will undoubtedly become even more critical, ensuring that nurses are well-equipped to deliver high-quality care in an increasingly complex healthcare environment.
Learn More Ways Simulation Can Improve Patient Safety!
References
- Alrajhi, H., Brown, J., & Smith, L. (2022). Improvements in practicing nurses’ knowledge, skills, self-efficacy, confidence, and satisfaction after a simulated clinical experience of caring for a patient undergoing chemotherapy: A quasi-experimental study. BMC Nursing, 21, Article 221. https://doi.org/10.1186/s12912-022-00821-4
- Johnson, M., & Smith, A. (2021). A comparison of the effects of teaching through simulation and the traditional method on nursing students’ self-efficacy skills and clinical performance: A quasi-experimental study. BMC Nursing, 20, Article 172. https://doi.org/10.1186/s12912-021-00672-3
- Kim, S., & Park, Y. (2023). Efficacy of a virtual nursing simulation-based education to provide psychological support for patients affected by infectious disease disasters: A randomized controlled trial. BMC Nursing, 22, Article 59. https://doi.org/10.1186/s12912-023-01123-9
- Lee, H., Choi, J., & Park, S. (2021). The effects of simulation-based education on self-efficacy and clinical performance in nursing students: A quasi-experimental study. BMC Nursing, 20, Article 161. https://doi.org/10.1186/s12912-021-00645-7
